Drug interactions
Fluconazole + Iloperidone
Severity: Major
Fluconazole and Iloperidone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Iloperidone is metabolized by CYP3A4 and CYP2D6 and prolongs the QT interval. Fluconazole increases iloperidone exposure and also has its own QT effect, so the combination raises the risk of torsades de pointes. Labeling recommends halving the iloperidone dose with strong CYP3A4 inhibitors, and fluconazole is a moderate inhibitor.
What this interaction means in plain words
Fluconazole and Iloperidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Fluconazole belongs to Anti Fungals; Iloperidone belongs to Central Nervous System.
Why it happens
Fluconazole inhibits CYP3A4 (and CYP2C19), increasing iloperidone levels, combined with additive QTc prolongation.
What to do
Avoid the combination if possible; otherwise consider reducing the iloperidone dose and monitor the ECG and electrolytes. Correct hypokalemia and hypomagnesemia.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
- Flibanserin + Fluconazole Contraindicated
Other interactions of Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Fluconazole with Iloperidone?
MediHelp rates the interaction as major. Fluconazole and Iloperidone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Iloperidone is metabolized by CYP3A4 and CYP2D6 and prolongs the QT interval. Fluconazole increases iloperidone exposure and also has its own QT effect, so the combination raises the risk of torsades de pointes. Labeling recommends halving the iloperidone dose with strong CYP3A4 inhibitors, and fluconazole is a moderate inhibitor.
How serious is the interaction between Fluconazole and Iloperidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible; otherwise consider reducing the iloperidone dose and monitor the ECG and electrolytes. Correct hypokalemia and hypomagnesemia.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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